2024 ONCOLOGY CERTIFICATION
NURSING EXAM WITH CORRECT
ANSWERS
infiltration - CORRECT-ANSWERSpassage or escape of IV administered drugs
into the tissue
extravasation - CORRECT-ANSWERSleakage of drugs capable of causing
tissue damage into the subcutaneous or subdermal tissue or other
unintended sites.
irritation - CORRECT-ANSWERSa localized inflammatory reaction at the
infusion or injection site
Cisplatin (Platinol) - CORRECT-ANSWERSalkylating agent
nephrotoxicity-monitor Cr, hydration, I's & O's, weights, diuretics, replace
K+, Mg
GI-N/V, acute and delayed
Neurologic-peripheral neuropathies, ototoxicity
vesicant potential
make sure you have blood return
cisplatin makes the kidneys go splat
Carboplatin (Paraplatin) - CORRECT-ANSWERSalkylating agent
myelosuppression-thrombocytopenia, neutropenia
GI-N/V
irritant to veins
hypersensitivity reaction
dosing based on AUC
doses 6-8 of carbo has an increased risk for hypersensitivity reaction.
Cyclophosphamide (Cytoxan) - CORRECT-ANSWERSalkylating agent
hemorrhagic cystitis-irritates the bladder, hydration, administer oral dose in
the am
GI-N/V
myelosuppression
secondary malignancies-increased risk for leukemia/breast cancer or other
cancers.
acroline-eats away at the bladder lining.
mesna-med to protect the bladder
,daily UA for blood, give hydration
Ifosfamide (flex) - CORRECT-ANSWERSalkylating agent
GU-hemorrhagic cystitis-daily UA for blood, mesna infusion, hydration, BUN,
Cr.
GI-N/V
Cutaneous-alopecia
Myelosuppression
Neurologic-neuro checks-confusion, coordination
irritant to veins.
mesna is always given with ifosfamide.
can give methylene blue to help with neurologic confusions.
neuro checks especially in older patients.
Melphalan (Alkeran) - CORRECT-ANSWERSnitrogen mustard alkylating agent
myelosuppression
N/V
Mucositis-irritates mucosal-hold ice in mouth while giving this therapy to help
decrease the mucositis.
be aware of blood counts
bone marrow transplant
Oxaliplatin (Eloxaitin) - CORRECT-ANSWERSalkylating agent
peripheral neuropathy-made worse with cold
myelosuppression
ideal to use with D5W
irritant with vesicant potential to veins
cannot have ice or cold drinks for 3-5 days after administration and should
also avoid cold air.
check blood cts before giving, may have to hold drug.
Bendamustine - CORRECT-ANSWERSalkylating agent (nitrogen mustard)
used in tx of CLL, NHL
bone marrow suppression
rash
irritant with vesicant-like properties
nausea-pre med with zofran/dex
hypersensitivity reaction including anaphylaxis. this is more common with
second or subsequent cycles.
hepatic and renal impairment
clinical pearls of alkylating agents - CORRECT-ANSWERS1. hypersensitivity
may occur with late doses of carboplatin (6-8)
2. tumor lysis syndrome-high tumor burden
3. assess BUN/creatinine, CBC w. differential
4. highly emetogenic lots of N/V
, 5. if oral route is given, administer in the am.
6. mesna (bladder protectant) is required for doses of ifosfamide, cytoxan.
7. for tumor lysis syndrome-give allopurinol to decrease of for prevention
8. also respuricase with help with tumor lysis syndrome
9. does not discriminate between cancer and non-cancer cells.
10. baseline audiogram for high dose cisplatin
11. alopecia
12. avoid exposure to cold during treatment of eloxatin (oxaliplatin)
antimetabolites - CORRECT-ANSWERS1. act in S phase-cell cycle specific
2. common side effects include: myelosuppression, GI toxicities, cutaneous
toxicities
3. routes: IV, SC, PO, IM, intrathecal, intraarterial.
Azacitidine (Vodaza) - CORRECT-ANSWERSantimetabolite
myelosuppression
monitor Cr
N/V/D
erythema at injection site-do not use ice on site and bruising
divide doses > 4 ml into two syringes
contraindicated in patients with sensitivity to Mannitol
drug is thick and causes bruising
roll drug between hands to warm
Capecitabine (Xeloda) - CORRECT-ANSWERSantimetabolite
oral route: take on full stomach with plenty of water
GI toxicities-N/V, mucositis, diarrhea, hepatotoxicity
cutaneous-hand-foot syndrome-monitor for redness, tingling and numbness
myelosuppression, anemia
potential drug interaction with warfarin
often taken at home-pt education is important
Clofarabine (Clolar) - CORRECT-ANSWERSantimetabolite
bone marrow suppression
risk for tumor lysis syndrome
N/V/D
hepatotoxicity
renal toxicity
potential for inflammatory response/ capillary leak syndrome
with capillary leak syndrome-altered mental status, swelling and
hypotension.
may give dexamethasone for side effects; increased risk for older patients.
monitor K+. Mg, uric acid, Cr and BUN
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